Hashimoto Yoshinori, Hosoda Rina, Omura Hiromi, Tanaka Takayuki
Department of Hematology, Tottori Prefectural Central Hospital.
Rinsho Ketsueki. 2020;61(11):1570-1576. doi: 10.11406/rinketsu.61.1570.
Central venous catheter (CVC) insertion is an essential medical procedure in patients with hematologic disorders. Recently, the use of peripherally inserted central venous catheters (PICCs) for CVC insertion has been increasing. However, the suitable arm for PICC insertion has not been fully discussed. This study retrospectively examined catheter-related complications on the insertion side of PICC in patients with hematologic disorders. Total 809 PICCs were inserted in 316 patients with hematologic disorders. The insertion side was the right upper arm for 515 PICCs and the left upper arm for 294 PICCs. In a direct comparison between the insertion side groups, there was no obvious difference in the basic demographic characteristics of the patients except the age at the time of insertion. Moreover, there was no significant difference in the reasons for PICC removal, and the incidence of catheter-related bloodstream infection was similar and low in both the study groups. During the selection of the insertion side for PICC, it may be possible to consider the side that seems more suitable for insertion by confirming the vessels in both upper arms with ultrasonography, and, if the conditions are equivalent, to consider the side where the patient wishes to insert the PICC.
中心静脉导管(CVC)置入是血液系统疾病患者的一项基本医疗操作。近年来,经外周静脉穿刺中心静脉导管(PICC)用于CVC置入的情况日益增多。然而,PICC置入的合适手臂尚未得到充分讨论。本研究回顾性分析了血液系统疾病患者PICC置入侧的导管相关并发症。共316例血液系统疾病患者置入了809根PICC。其中515根PICC的置入侧为右上臂,294根PICC的置入侧为左上臂。在置入侧组之间的直接比较中,除置入时的年龄外,患者的基本人口统计学特征无明显差异。此外,PICC拔除原因无显著差异,两组的导管相关血流感染发生率相似且较低。在选择PICC置入侧时,可通过超声检查确认双侧上臂血管,考虑似乎更适合置入的一侧;若条件相当,可考虑患者希望置入PICC的一侧。